The Medical journal of Australia
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Surveys of ear disease amongst Aboriginal people in two isolated bush communities (Wiluna and La Grange) and one urban community (Kwinana) in Western Australia were undertaken in 1988 or 1989. The age-adjusted prevalence odds ratio (relative risk) of perforations of the tympanic membrane for Wiluna compared with Kwinana was 5.0 (95% confidence interval [CI] 2.7-12.2) and 6.8 (95% CI 3.5-13.9) for La Grange compared with Kwinana. ⋯ There was no significant difference in the relative risk of moderate or severe hearing loss or impedance pattern B, usually interpreted as "glue ear", in any of the three communities. Overall, the urban Aboriginal community had less ear disease and hearing loss than either of the isolated bush communities, but even this community did not approach the much lower levels of prevalence in Australia as a whole.
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Mortality is an important measure of the extent of the health disadvantages experienced by Australia's Aborigines. In the absence of routinely available data on Aboriginal deaths, this paper has collated information from a number of sources. ⋯ Despite improvements in some indices of mortality, the death rates of Aborigines, particularly for young and middle-aged adults, are unacceptably higher than those of non-Aboriginal Australians. Without substantial reductions in death rates, the expectation of life of Aborigines will remain comparable with that of people living in developing countries.
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This case report illustrates the threat to life posed by tiger snake venom-induced coagulopathy, the importance of first-aid, precautions with antivenom administration, the dose of antivenom and the necessity to monitor the coagulation status. ⋯ More public education is required in first-aid management of snake envenomation. Frequent monitoring of coagulation status is necessary to optimise antivenom and coagulation factor therapy.